Ethics committee supports patients, providers

In the ever-changing world of healthcare, medical professionals often encounter situations that require them to examine moral principles and guidelines governing healthcare decisions. Ethical decision-making is a process that aims to balance core ethical principles in order to make challenging decisions.

William Grinstead, MDiv, ThM, BCC, HEC-C, is the regional ethicist for the IU Health East Region. He plays a key role in helping team members, patients and families navigate complex clinical decisions, such as initiating or discontinuing life-sustaining interventions and advising leaders on ethical decision-making for their unit or service line in alignment with ethical principles and the IU Health values.

Grinstead began his career as a general hospital chaplain. During his clinical training, he encountered a situation where he advocated for a patient’s religious beliefs. The patient’s health condition could have been treated successfully if he had chosen to abandon his beliefs, but the patient remained adamant. While Grinstead admired the patient’s commitment, he recognized the patient’s care team's dilemma. He assisted the team in communicating the patient’s condition to his family and helping them process their distress over the patient’s decision.

After his clinical training, Grinstead wanted to expand his role in addressing and facilitating ethical dilemmas. He attended the Fairbanks Center for Medical Ethics at IU Health’s Academic Health Center, where he developed clinical expertise in ethics consultation through the ethics fellowship program.

Over the past ten years, Grinstead has honed and applied new communication skills with patients, their families and the team members who care for them, as part of the Palliative Care team.

The demand for clinical ethics support increased during and after the COVID-19 pandemic, prompting the East Region team to rethink some approaches to this work, including revamping the regional ethics committee in 2024. Grinstead, Kellen McCormack, RN, Operational Excellence, and Ahmed Behery, MD, from the Hospitalist department, contribute their unique clinical backgrounds, case consultation experiences, and business acumen to help navigate challenging situations.

“An advantage of the committee is that we’ve created a multidisciplinary approach that allows multiple perspectives to address complex ethical and moral issues,” says McCormack.

Dr. Behery serves as a bridge between physicians, APPs and the ethics committee.

“The most important thing is helping my colleagues understand the role of the ethics committee and how to engage with it,” he says. “I can also provide clinical insight for ethics consults brought to the committee.”

The team also facilitates Unit-Based Ethics Conversations (UBEC), an evidence-based intervention that helps team members identify and process ethical issues, particularly moral distress. Moral distress occurs when a team member recognizes the right course of action but is prevented from taking it due to external factors or internal constraints. UBECs help team members uncover the core ethical tensions beneath emotions about how a case is handled or how standard practices are implemented.

The committee remains committed to supporting team members who strive to do the right thing—even when the right course of action is unclear.